The current grant is designed to continue to study clinical human transplantation (especially renal and pancreatic transplantation) in an attempt to document the problems and to obtain potential solutions to those problems which can be answered by laboratory investigation. In particular, we are continuing to study transplantation in high risk patients, especially those with metabolic diseases, diabetes, children and aged patients. Special emphasis is placed on the clinical development of antilymphoblast globulin, the correlation of clinical results with in vitro immunologic studies, studies of histocompatibility typing, cross matching and transplantation in previously sensitized patients. A continuing study of the clinical-virological correlations between the fate of renal transplant patients who develop viral infections with herpesviruses. Pancreatic transplantation has switched to the transplantation of islets in animals and man. Such islets have been shown to reverse and prevent the vascular complications of diabetes, and new techniques for the isolation and purification of islets are being carried out. New methods for hemodialysis of pediatric patients, for relief of the complications of hemodialysis and for the immunopathologic study of kidney diseases is also included. BIBLIOGRAPHIC REFERENCES: Barbosa, J., Burke, B., Buselmeier, T.J., Carpenter, A.-M., Goetz, F.C., Harris, J., Kennedy, W.R., Kjellstrand, C.M., Michael, A.F., Najarian, J.S., and Recker, L.: Neuropathy, retinopathy and biopsy findings in transplanted kidneys in diabetic patients. Kidney International 6:S32, 1974.; DeShazo, C.V., DeShazo, M.M., and Najarian, J.S.: Renal transplantation in 100 children. Transplant. Proc. VII:713, 1975.